Endocrine Abstracts

Introduction: The diagnosis of Cushing’s syndrome is frequently invoked by the presence of clincal signs of hypercatabolism. It actually may be associated with a variety of dermatological manifestations which can be atypical. Here, we report the case of a patient having vulvar warts co-occuring with Cushing’s syndrome.

Observation: We present the case of a 31-year-old patient presenting with typical signs of Cushing’s syndrome: Facial erythrosis, facio-truncular fat distribution, buffalo hump, abdominal obesity with a waist circumference of 98 cm and purple stretch marks on the abdominal and axillary areas, he also had muscular amyotrophy in te lower limbs and BP: 18/10. While examining the patient, we identified atypical dermatological manifestations: vulgar warts on the dorsal surfaces of the both hands simultaneously with the appearance of signs of Cushing’s disease. We confirmed a cushing’s syndrome by a low-dose dexamethasone suppression test which was positive, an elevated ACTH, the absence of braking in the High-dose dexamethasone suppression Test. The MRI showed a pituitary microadenoma. The other axes were explored and he presented with isolated hypogonadtrophic hypogonadism. As for the complications he presented diabetes, hypertension and osteoporosis.

Conclusion: Long-term exposure to intrinsic corticosteroids during cushing’s disease induct immunosuppression which can be the cause of these atypical dermatological manifestations. It is crucial to know how to invoke endocrinopathies like Cushing’s syndrome in patients presenting not only the typical signs of the pathology but also atpyical manifestations.